LAUSR

decision to pursue aggressive resuscitation, even if that resuscitation fails to directly benefit the trauma patient before them. Trauma patients with pre-existing first person consent for organ donation are a population for whom there is an intrinsic patient-centric benefit to aggressively resuscitate. Siminoff and Lawrence found that “having knowledge of a patient’s preference to donate increased the likelihood of donating by 6.90 times.” However, Christmas and colleagues found that while Department of Motor Vehicles designation for organ donation increased the yield of consent for organ donation, 20% of families ultimately denied consent for donation. These findings highlight the inherent challenges in knowing a trauma patient’s preference for organ donation and raise the question of whether aggressive resuscitation is acceptable practice for all comers. If 98.5% of DOA trauma patients will not live to a functionally independent discharge, there are harms associated with aggressive resuscitation. These vulnerable patients cannot consent to the loss of bodily integrity, dignity, normal opportunities, and ultimately, organ donation. Patient racial demographics were not discussed in this study, but are relevant and should be considered. There are different donation and recipient rates among racial groups. According to Minniefield and colleagues, 38% of blacks said they would not donate organs compared with 10% of whites. When blacks were asked why they would not donate organs, 46% expressed a lack of trust for doctors compared with 23% of whites. It is therefore imperative that a nonevidence-based practice with limited patient benefit be ethically justified.